A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer
BackgroundMedullary thyroid cancer (MTC) can only be cured by surgery, but the management of lateral lymph nodes is controversial, especially for patients with cN0+cN1a. To address this challenge, we developed a multivariate logistic regression model to predict lateral lymph node metastases (LNM).Me...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.902546/full |
| _version_ | 1828151682641428480 |
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| author | Lichao Jin Xiwei Zhang Song Ni Dangui Yan Minjie Wang Zhengjiang Li Shaoyan Liu Changming An |
| author_facet | Lichao Jin Xiwei Zhang Song Ni Dangui Yan Minjie Wang Zhengjiang Li Shaoyan Liu Changming An |
| author_sort | Lichao Jin |
| collection | DOAJ |
| description | BackgroundMedullary thyroid cancer (MTC) can only be cured by surgery, but the management of lateral lymph nodes is controversial, especially for patients with cN0+cN1a. To address this challenge, we developed a multivariate logistic regression model to predict lateral lymph node metastases (LNM).MethodsWe retrospectively collected clinical data from 124 consecutive MTC patients who underwent initial surgery at our institution. The data of 82 patients (from 2010 to 2018) and 42 patients (from January 2019 to November 2019) were used as the training set for building the model and as the test set for validating the model, respectively.ResultsIn the training group, the multivariate analyses indicated that male and MTC patients with higher preoperative basal calcitonin levels were more likely to have lateral LNM (P = 0.007 and 0.005, respectively). Multifocal lesions and suspected lateral LNM in preoperative ultrasound (US) were independent risk factors (P = 0.032 and 0.002, respectively). The identified risk factors were incorporated into a multivariate logistic regression model to generate the nomogram, which showed good discrimination (C-index = 0.963, 95% confidence interval [CI]: 0.9286–0.9972). Our model was validated with an excellent result in the test set and even superior to the training set (C-index = 0.964, 95% CI: 0.9121–1.000).ConclusionHigher preoperative basal calcitonin level, male sex, multifocal lesions, and lateral lymph node involvement suspicion on US are risk factors for lateral LNM. Our model and nomogram will objectively and accurately predict lateral LNM in patients with MTC. |
| first_indexed | 2024-04-11T22:01:06Z |
| format | Article |
| id | doaj.art-32d8823b4cda4001916dc99dcf088400 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-11T22:01:06Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-32d8823b4cda4001916dc99dcf0884002022-12-22T04:00:56ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-08-011310.3389/fendo.2022.902546902546A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancerLichao Jin0Xiwei Zhang1Song Ni2Dangui Yan3Minjie Wang4Zhengjiang Li5Shaoyan Liu6Changming An7Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaBackgroundMedullary thyroid cancer (MTC) can only be cured by surgery, but the management of lateral lymph nodes is controversial, especially for patients with cN0+cN1a. To address this challenge, we developed a multivariate logistic regression model to predict lateral lymph node metastases (LNM).MethodsWe retrospectively collected clinical data from 124 consecutive MTC patients who underwent initial surgery at our institution. The data of 82 patients (from 2010 to 2018) and 42 patients (from January 2019 to November 2019) were used as the training set for building the model and as the test set for validating the model, respectively.ResultsIn the training group, the multivariate analyses indicated that male and MTC patients with higher preoperative basal calcitonin levels were more likely to have lateral LNM (P = 0.007 and 0.005, respectively). Multifocal lesions and suspected lateral LNM in preoperative ultrasound (US) were independent risk factors (P = 0.032 and 0.002, respectively). The identified risk factors were incorporated into a multivariate logistic regression model to generate the nomogram, which showed good discrimination (C-index = 0.963, 95% confidence interval [CI]: 0.9286–0.9972). Our model was validated with an excellent result in the test set and even superior to the training set (C-index = 0.964, 95% CI: 0.9121–1.000).ConclusionHigher preoperative basal calcitonin level, male sex, multifocal lesions, and lateral lymph node involvement suspicion on US are risk factors for lateral LNM. Our model and nomogram will objectively and accurately predict lateral LNM in patients with MTC.https://www.frontiersin.org/articles/10.3389/fendo.2022.902546/fullmedullary thyroid cancerlateral lymph node metastasesnomogramprophylactic lateral neck dissectioncalcitonin, |
| spellingShingle | Lichao Jin Xiwei Zhang Song Ni Dangui Yan Minjie Wang Zhengjiang Li Shaoyan Liu Changming An A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer Frontiers in Endocrinology medullary thyroid cancer lateral lymph node metastases nomogram prophylactic lateral neck dissection calcitonin, |
| title | A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer |
| title_full | A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer |
| title_fullStr | A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer |
| title_full_unstemmed | A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer |
| title_short | A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer |
| title_sort | nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer |
| topic | medullary thyroid cancer lateral lymph node metastases nomogram prophylactic lateral neck dissection calcitonin, |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.902546/full |
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